Babies and falls

Whenever your baby or toddler takes a serious tumble — from a couch, bed, highchair, crib, or countertop, for example — you'll need to do a thorough check for injuries, especially if he falls on his head or back.

You'll want to make sure that your child doesn't have any serious wounds, that he hasn't broken any bones, and that he hasn't suffered a concussion or other internal damage, including a serious head injury (such as a skull fracture or intracranial injury). Falls can be serious, but because baby and toddler bones are soft, they don't fracture as easily as those of an older child.

If your child looks okay to you and seems to be acting normally, chances are the fall didn't cause serious injury. Be thankful, but keep an eye on him. Continue to carefully observe your him for the next 24 hours, especially if he bumped or fell on his head.

Err on the side of caution: If you're uncomfortable with the severity of your child's fall — you think he must have gotten hurt — or if your child is acting irritable or confused, take him to the doctor to get checked out.

It's not necessary to keep your child awake after a fall, although if he is awake it'll be easier to monitor whether he's acting okay.

Call 911 if your child experiences any of the following after a fall:

A loss of consciousness. If your child isn't breathing, have someone call 911 while you administer infant cardiopulmonary resuscitation (CPR) (if your child is younger than 12 months) or cardiopulmonary resuscitation (CPR) (if your child is 12 months or older) until help arrives. If you're alone, give your child CPR for two minutes, then call 911 yourself.
Bleeding that you're unable to stop with pressure.
A seizure.
If your child is breathing but not responsive — he's unconscious after the fall or you're unable to wake him up after he goes to sleep, for example.
Take your child to the emergency room or talk to his doctor immediately if you notice any of the following:

Signs of a broken bone, including an obvious deformity, like a wrist that's bent awkwardly, or an arm or a leg that seems out of alignment
Signs of a possible skull fracture: A soft, swollen area on the scalp, especially on the side of the head (above or behind the ear); blood showing in the whites of his eyes; or pinkish fluid or blood draining from his nose or ears
Signs of a concussion, such as persistent vomiting or excessive sleepiness. Depending on your child's age, look for a change in how he crawls or walks; headache or dizziness; weakness or confusion; or problems with speech, vision, or motor skills
Signs of a possible brain injury, such as changes in pupil size and unusual eye movements
Prolonged crying or screaming, which could indicate a possible internal injury such as abdominal bleeding

What should I do if my child develops a bump on his head?

"Goose eggs" on the head are common, especially in children who are just learning to get around by themselves. Although a bump on the head can look scary, it doesn't necessarily mean that your child is seriously hurt. When swelling occurs on the head, much of it protrudes outward because your child's skull is just under the skin.

To help the bump go down, wrap an ice pack (or a bag of frozen peas, in a pinch) in a thin towel or diaper and hold it on the bump for two to five minutes at a time, off and on, for an hour. Nursing or feeding your baby or looking at a book with your toddler during this time can help distract him from the chill and discomfort.

If you think that your child is bothered by the bump, ask his doctor about giving him the appropriate dose of acetaminophen or ibuprofen. Never give your child aspirin, which can lead to a rare but serious condition called Reye's syndrome.

Minor bumps and bruises are an unavoidable part of developing motor skills and independence.As long as your child is under constant adult supervision and his play area is free of ungated stairs, sharp edges, and other hazards, most falls will not cause serious injury.

When your child does take a tumble, try not to overreact. Rushing to his side every time he stumbles will wear you out and make him overly cautious. If he's upset, calmly comfort him and encourage him to get back on his feet. Still, falls are the number-one cause of accidental injury in children, and 1 in 3 of these accidents is preventable.

Do what you can to keep your child safe, including:

Cushion sharp corners on furniture. Because they're low, coffee tables are common culprits in childhood bumps and bruises. You may want to pad the corners of your coffee table, or you may find it worthwhile to pack the table away until your child is a confident, steady walker.
Put skidproof pads under all rugs. Or remove throw rugs until they no longer trip up your child. And use a nonslip mat to keep your child from sliding once you're bathing him in the big tub.
Keep your child away from elevated porches and decks, and place gates at the top and bottom of each staircase. (Choose a mesh gate rather than the accordion style, which can trap and pinch little fingers.) Place guards or acrylic glass sheets (such as Plexiglass) on banisters and railings if your child can fit through the rails.
Move chairs and other furniture away from windows..
Be extra vigilant about holding your baby or toddler on the changing table. Some tables have straps that can help you keep your grip on a real wiggler, but they may not be enough to prevent a fall, so don't ever leave your child on the table unattended.
Keep the stairs in your home free of objects that you might trip over when you're carrying your child.
Lower your child's mattress as soon as he starts standing up in his crib.
When you're at the grocery store, buckle your child into the shopping cart. And don't walk away from the cart, even for an instant. Also strap your child into his stroller and his highchair.
Keep a sharp eye on your child at all times if he's started climbing on the furniture. You'll want to act quickly to keep him from falling.
Use window guards on windows. Don't rely on screens, which aren't designed to keep kids from falling out.